心理健康污名：二元论、不确定性、因果关系和可治疗性的作用,General Psychiatry

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心理健康污名：二元论、不确定性、因果关系和可治疗性的作用
General Psychiatry ( IF 5.3 ) Pub Date : 2021-07-01 , DOI: 10.1136/gpsych-2021-100498
Javed Latoo _{1,

2} , Minal Mistry ₃ , Majid Alabdulla _{1,

2} , Ovais Wadoo ₁ , Farida Jan ₄ , Tariq Munshi ₅ , Yousaf Iqbal ₁ , Peter Haddad _{1,

2}

Affiliation

公众对心理健康的污名被定义为“促使个人害怕、拒绝、避免和歧视患有精神疾病的人的一系列消极态度和信念”。1 污名给全球的精神障碍患者带来了巨大的痛苦。根据人权观察最近的一份报告，有精神健康问题的人仍然在 60 个国家受到束缚。2 在英格兰，每 10 个精神健康服务使用者中就有近 9 个遭受过歧视。 3 各行各业的人都可以使污名化，包括精神障碍患者的家人和朋友，以及医疗保健专业人员，包括从事精神卫生工作的人员。污名化的不利后果包括羞耻、自责、孤立和歧视。4 精神健康障碍患者遭受歧视的例子包括其他人逃避他们的陪伴，以及教育、就业和住房机会被拒绝。5 污名会阻止精神健康问题患者寻求帮助并导致治疗依从性差。与一般人群相比，精神障碍患者的身体共病率和死亡率都较高。6 7 造成这些健康差异的原因是多方面的，但据信歧视和诊断掩盖是促成因素。8 精神健康污名有很多原因，包括缺乏知识和不准确的信念，尤其是关于精神疾病和暴力行为之间的关系。 9 在本文中，我们强调身心二元论，并低估了精神障碍和身体障碍之间可能存在的相似性作为污名化的促成因素。关于精神病学的负面假设包括它涉及不确定性、对疾病的原因知之甚少以及可治疗性差的病症。这些是误导性的概括，但与本文更相关的是，在精神病学和普通医学中都可以遇到这些特征。大脑是最... 但与本文更相关的是，在精神病学和普通医学中都可以遇到这些特征。大脑是最... 但与本文更相关的是，在精神病学和普通医学中都可以遇到这些特征。大脑是最...

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Mental health stigma: the role of dualism, uncertainty, causation and treatability

Public stigma on mental health has been defined as ‘the set of negative attitudes and beliefs that motivate individuals to fear, reject, avoid and discriminate against people with mental illness’.1 Stigma causes immense suffering to people with mental disorders across the globe. According to a recent Human Rights Watch report, people with mental health conditions are still shackled in 60 countries.2 Nearly nine out of 10 mental health service users in England have experienced discrimination.3 Stigma can be perpetuated by people in all walks of life, including the family and friends of those with mental disorders, and healthcare professionals, including those working in mental health. The adverse consequences of stigma include shame, self-blame, isolation and discrimination.4 Examples of discrimination experienced by people with mental health disorders include others avoiding their company, and education, employment and housing opportunities being withheld.5 Stigma can deter people with mental health problems from seeking help and leads to poor adherence to treatment. People with mental disorders have high rates of physical comorbidity and higher mortality compared with the general population.6 7 The reasons for these health disparities are multifactorial, but discrimination and diagnostic overshadowing are believed to contribute.8 Mental health stigma has many causes including lack of knowledge and inaccurate beliefs, especially regarding the relationship between mental illness and violent behaviour.9 In this article, we highlight mind–body dualism and an underappreciation of the similarities that can exist between mental and physical disorders as contributory factors to stigma. Negative assumptions about psychiatry include it involving uncertainty, the causation of disorders being poorly understood and conditions having poor treatability. These are misleading generalisations, but more relevant to this article is the fact that these features can be encountered in both psychiatry and general medicine. The brain is the most …

更新日期：2021-07-05

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